Tyler Medical Clinic Inc

NPI 1003869892 - Clinic/Center - 261Q00000X

NPI Details
NPI 1003869892
Enumeration Date 05/19/2006
Last Updated 03/23/2016
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name JONATHAN DEAN JONATHAN
Position ADMINISTRATOR/CEO
Phone (507) 368-4654
Fax (507) 368-4546
Practice Location
109 E BENTON ST
LAKE BENTON MN, 56149-1309, US
Phone (507) 368-4654
Fax (507) 368-4546
Business Location
109 E BENTON ST
LAKE BENTON MN, 56149-1309, US
Phone (507) 368-4654
Fax (507) 368-4546
Toxanomy
Taxonomy Code 261Q00000X
License State Minnesota
License Number 410853183
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According to our database, Tyler Medical Clinic Inc NPI is 1003869892, taxonomy code is 261Q00000X and license number is 410853183, license state is located at Minnesota. Tyler Medical Clinic Inc physically located at 109 E Benton St, Lake Benton MN, 56149-1309. NPI Number 1033115704 has the healthcare provider type.

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1003869892 NPI number is provided on an as is basis without warranty of any kind. 1003869892 is maintained by the National Plan & Provider Enumeration System. The contents of Tyler Medical Clinic Inc are for informational purposes only.